Health education as a strategy to promote the development of the prematurely born child: perception of caregivers

The birth of a premature baby can cause impairment in the child's development, requiring a critical analysis from the health professional of their performance in the care directed to this public and their family. There is lack of scientific literature focused on the promotion of functional development of premature infants, making necessary the use of technologies that help the family in home care. Objective: To understand the knowledge and practices of caregivers of prematurely children, about the functional development mediated by an intervention with an educational technology. This was a qualitative, descriptive, exploratory and intervention research, with 11 mothers of prematurely born children, followed up by a service in a city of Minas Gerais. Performed in three steps. The first still in the follow up service, the second and third consisted of home visits. The analysis originated the categories “Expectations related to the educational material”, “Experiences with the educational material” and “Changes in care aroused by the appropriation of the educational material”. The work of the health educator articulated with an educational technology focused on promoting the child development of premature children contributes to the resignification of knowledge and everyday practices of care directed to this public

Educational technology effectiveness in home stimulation of preterm infants: a non-randomized clinical trial

Introdução: A efetividade das Tecnologias Educacionais (TE) elaboradas para auxiliar tanto a função educativa precípua do enfermeiro, quanto o apoio às famílias de prematuros na promoção do desenvolvimento infantil, é pouco conhecida. Objetivo geral: Analisar a efetividade da TE \"História de Sofia: Batalhas e Conquistas da família no cuidado e desenvolvimento da criança prematura sobre a estimulação no ambiente domiciliar de lactentes nascidos prematuros. Método: Ensaio clínico pragmático, não randomizado, em unidade de terapia intensiva neonatal de um hospital privado, em São Paulo, SP. Foram incluídos familiares de lactentes prematuros e excluídos aqueles ausentes em três contatos para agendamento. A coleta em visita domiciliar, de maio a novembro de 2018, levantou características ambientais e familiares dos lactentes e sua estimulação foi avaliada com o inventário Home Observation for Measurement of the Environment Scale, versão 0 a 3 anos (IT- HOME). Todos os participantes receberam a orientação de alta hospitalar padronizada no serviço; a TE foi doada ao grupo experimental (GE); o grupo controle (GC) não teve contato com a TE. O estudo seguiu a Resolução 466/12 do Conselho Nacional de Saúde e registrado na plataforma virtual de Registro Brasileiro de Ensaios Clínicos (Identificador primário: RBR-2SK64P) com autorização dos Comitês de Ética em Pesquisa da Escola de Enfermagem da Universidade de São Paulo e do Hospital e Maternidade Rede DOR São Luiz (Protocolos dos pareceres: 2.542.890 e 2.648.329). Na análise dos dados, foram comparados os grupos e escores do IT-HOME com variáveis de interesse. Para a comparação de variáveis numéricas utilizou testes t, Wilcoxon-Mann-Whitney ou Brunner-Munzel, ANOVA e teste Kruskal-Wallis. A comparação de variáveis categóricas usou o teste qui-quadrado ou exato de Fisher e a correlação foi medida pelo coeficiente Spearman. Resultados: O GC foi composto por 30 famílias, sendo 5 com lactentes gemelares e o GE 32 famílias com 3 gemelares. As pontuações médias do IT HOME foram 30,23 para o GE, e 26,57 para o GC, evidenciando mais estimulação domiciliar para o GE (p=0,001). O GE teve pontuações superiores ao GC nas subescalas: ausência de punição e restrição (GE=5,03; GC=4,46; p=0,005); disponibilidade de materiais de brinquedos e jogos apropriados (GE=4,14; GC=3,03; p=0,001); envolvimento materno com a criança (GE=3,8; GC=2,37; p<0,001); oportunidade de variação na estimulação diária (GE=3,26; GC=2,8; p=0,025). Não houve diferença significativa nas escalas: responsividade emocional e verbal da mãe (GC=9,54; GE=9,6; p=0,513); organização do ambiente físico e temporal (GC=4,37; GE=4,4; p=0,836). As variáveis que influenciaram as pontuações do IT-HOME foram: relatos de aspectos mais positivos pelas mães; preparo familiar para chegada do bebê por meio de leitura de materiais sobre cuidados com o bebê e/ou desenvolvimento infantil, ou realização de curso preparatório; utilizar Unidade Básica de Saúde para o cuidado com o bebê; atividades prazerosas com o bebê. A maior parte das mães gostou da TE pela leitura fácil e identificação com a história e utilizou o material como fonte de informações. Conclusão: A TE foi efetiva para a promoção de estímulos domiciliares aos lactentes nascidos prematuros.Introduction: The effectiveness of Educational Technologies (TE) designed to support both the primary educational role of nurses and support for families of preterm infants in promoting child development is poorly understood. Objective: To analyze the ET effectiveness \"History of Sofia: Family Battles and Achievements in the Care and Development of the Premature Child in Home-Based Stimulation of Infants Born Premature.\" Methods: Non-Randomized Pragmatic Clinical Trial in a private hospital neonates Intensive Care Unit from the city of São Paulo, SP, Brazil, which included relatives of infants in any level of prematurity and excluded those who were absent in the collection attempts. The home visit collection, from May to November 2018, raised the environmental and familial characteristics of the infants and their stimulation was evaluated by Home Observation for Measurement of the Environment Scale, version 0 to 3 years (IT-HOME). All participants received a standardized discharge from the service, the ET was donated to the experimental group (EG), the control group (CG) had no contact with ET. The study followed Council Resolution 466/12 (RBR-2SK64P) with Research Ethics Committees of the School of Nursing of the University of São Paulo and the São Luiz DOR São Luiz Hospital and Maternity Hospital authorizations (Brazilian National Registry of Clinical Trials Protocols: 2,542,890 and 2,648,329). In data analysis, IT-HOME groups and scores were compared with variables of interest. For the comparison of numerical variables, it was used T-Test, Wilcoxon-Mann- Whitney or Brunner-Munzel, ANOVA and Kruskal-Wallis tests. Comparison of categorical variables used the chi-square or Fisher\'s exact test and the correlation was measured by the Spearman coefficient. Results: Both groups included 35 infants. Mean scores for IT HOME were 30.23 for the SG, and 26.57 for the CG, showing more home stimulation for the SG (p = 0.001). The GE had scores higher than the GC in the subscales: no restriction and punishment (GE = 5.03, GC = 4.46, p = 0.005); availability of appropriate toys and games materials (GE = 4.14, GC = 3.03, p = 0.001); maternal involvement with the child (GE = 3.8, GC = 2.37, p <0.001); opportunity for variation in the stimulation of daily life (GE = 3.26, GC = 2.8, p = 0.025). There was no significant difference in the scales: emotional and verbal responsiveness of the mother (GC = 9.54, GE = 9.6, p = 0.513); organization of the physical and temporal environment (GC = 4.37, GE = 4.4, p = 0.836). The variables that influenced the IT-HOME scores were: more positive aspects reports by mothers; family preparing for the baby coming by baby care/child development reading, or preparatory course; use the Basic Health Unit to care for the baby; pleasant activities with the baby. Most mothers liked TE for easy reading and identification with the story, who used the material as an information source. Conclusion: The ET was effective for the promotion of infants home stimulation inborn preterm